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Human Papillomavirus (HPV) infection is very common in sexually active men and women. HPV vaccination is the most effective measure for primary prevention for HPV infection and HPV-related diseases ultimately. HPV infection can cause condylomata acuminata in males, and is also associated with penile cancer, anal cancer and oral cancer; however, most male HPV carriers do not have signs or symptoms, so prevention and treatment of HPV infection in men can effectively reduce the risk of HPV infection in their partners. In most countries the HPV vaccination coverage among females is far lower than targeting expectation, and the effective herd immunity has not been achieved yet. Men can directly benefit from HPV vaccination, which is also beneficial for their partners, therefore HPV vaccination for men is worth considering. In this article we briefly describe HPV vaccination in males and overview their awareness and acceptance of HPV vaccination, so as to provide references for promoting HPV vaccination among men in the future.
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Objective:To investigate the perspective of family doctor teams on the status quo of home care for community-dwelling elderly.Methods:The focus group interviews on the status quo of home care for community-dwelling elderly were conducted from August 19 to December 28, 2021. One urban area and 1 suburban area of Beijing was selected by purpose sampling method as target areas. Five community health service centers were selected from each area, and 5 family doctor team members were selected as interviewees in each center. The outline of interviews was as follows: what kinds of home care does the family doctor team provide for the community-dwelling elderly; how does the family doctor team evaluate the existing community-based home care; what suggestions on developing community-based home care for the elderly in the future. The data of the interview were analyzed by the thematic framework.Results:Xicheng district and Miyun district were selected as the study sites in the urban and suburban areas of Beijing, and 41 family doctor team members were interviewed. Three themes and 6 sub-themes were extracted. The study showed that: (1) the family doctor contracted service for the elderly was carried out smoothly in the community; (2) the current situation of home care for the elderly in the community varied, the chronic disease management for the elderly was effective, the health education in the community was popular, the implementation of free annual health check for the elderly in urban areas was more difficult than that in suburban areas, and the family doctor team provided home visits as needed and required; (3) the members of family doctor team usually undertook multiple tasks due to the insufficiency of auxiliary staff, and the incentive mechanism of the home visit was not perfect, which needed to be improved.Conclusion:From the perspective of family doctor teams, the contract service for the elderly is generally carried out smoothly in Beijing communities, but it varies in different types of home care for the elderly, and the work and incentive mechanism of family doctor team need to be improved.
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Objective:To survey the experiences and perception of caregivers on home care service for community-dwelling elderly.Methods:From August to December 2021, individual semi-structured in-depth interviews were conducted with caregivers of the elderly from five community health centers in Beijing Xicheng and Miyun districts selected by purposive sampling.Results:Nine caregivers,2 males and 7 females aged 49-76 (62.8±9.4) years were interviewed in this study. The nursing care period was 3-48 (17±13) years. Four themes were extracted from the interview data: older people′s own condition was the primary factor influencing the home care needs; medical needs for home care were determined by the caregivers′ factors; community health service was important for meet home medical needs; and supporting of home care services for the elderly need to be strengthened.Conclusion:The experience of elderly home caregivers in using community home medical services is affected by many factors, and in the future, the content of home medical services should be improved, and the skills training of community elderly home caregivers should be strengthened, so as to improve the quality of life at home and promote the health literacy of the elderly.
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Objective:To investigate the past continuing medical education (CME) in pediatrics for general practitioners in community health centers in Longhua District, Shenzhen, so as to explore the willingness, needs and suggestions of general practitioners for CME in pediatrics.Methods:A mixed methods research were used in this study. Firstly, the purpose sampling method was used to select general practitioners in community health centers in Longhua District, Shenzhen for personal in-depth interviews. The interview contents were recorded and transcribed. The interview contents were coded by NVivo software. Theme frame analysis method was used for data sorting and theme extraction. Based on the results of qualitative interviews, the questionnaire was developed and distributed through the electronic questionnaire platform, and relevant questionnaire data were analyzed by Excel.Results:The results of qualitative research showed that after personal in-depth interviews with 10 general practitioners, the information reached saturation. Through repeated reading, induction and analysis of the interview data, four themes were extracted: ① previous pediatric training opportunities and satisfaction; ② willingness to participate in pediatric training; ③ the demand of training content, form and duration; ④ measures to encourage participation in training. In terms of quantitative research results, a total of 223 electronic questionnaires were collected, among which there were 219 valid questionnaires. Besides, 150 (68.5%) general practitioners said that they had no or only a few training opportunities in pediatrics CME in the past. There were some problems in the past CME training, such as unsystematic training (39 practitioners, 66.1%), narrow course coverage (30 practitioners, 50.8%), the content divorced from clinical practice (29 practitioners, 49.2%), monotonous teaching method (27 practitioners, 45.8%), etc. And 210 (95.9%) general practitioners were willing to participate in pediatric training, and 161 (73.5%) hoped that the form of training would be a combination of online and offline. In terms of pediatrics specialty content training needs, the general practitioners had higher demand for respiratory (188 practitioners, 85.8%), digestive (160 practitioners, 73.1%), infectious (145 practitioners, 66.2%) and dermatology (136 practitioners, 62.1%) specialty.Conclusion:There are still some problems in pediatrics CME, such as few training opportunities, unsystematic training, etc. In the future, we need to formulate systematic training plans and incentive measures according to the needs of general practitioners, to strengthen the pediatric professional training for general practitioners and improve their ability to receive children, in order to promote the implementation of hierarchical medical system for children.
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Objective:To investigate the status quo of nursing capacity for chronic respiratory disease in community health service centers.Methods:A questionnaire survey on nursing capacity for chronic respiratory disease was conducted in November 2018 among nurses working in internal medicine, general practice and chronic disease management departments of 4 community health service centers in Beijing Miyun District. The questionnaire included the knowledge and work content of chronic respiratory diseases. At the same time semi-structured interviews was conducted on the role of nurses in the management of chronic respiratory diseases among nurses selected by purposive sampling method.Results:In the study 63 valid questionnaires were collected and 14 nurses were interviewed. The results showed that the total score of nurses′ knowledge about chronic respiratory diseases was (62.0±14.4), and the scores of knowledge of chronic obstructive pulmonary disease (COPD), bronchial asthma and obstructive sleep apnea were (55.5±19.3), (61.0±21.6), (69.5±25.1), respectively. The total knowledge score of nurses with middle-rank professional title or above was higher than that of those with primary title [(67.0±12.9) vs. (54.0±13.6), t=-3.07, P<0.01]. The work contents mainly involved were nursing procedures(22/63,34.9%), health education(18/63,28.6%) and nursing evaluation(8/63,12.7%).Three themes were extracted from the deep interviews: the main work contents for nurses should be nursing procedures, nurses should participate in the chronic respiratory disease management as a member of the integrated medical team; nurses expected practice-oriented trainings of chronic respiratory disease management. Conclusions:The knowledge of chronic respiratory diseases among nurses in community health center needs to be improved, and the nursing skills special for respiratory diseases are needed. It is suggested to develop training courses and nursing guidelines suitable for community health centers and for nurses to participate in chronic respiratory disease management as team members, so that nurses in primary care institutions can play a better role in the management of chronic respiratory diseases.
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Objective:To investigate the status quo and related issues of reception of pediatric patients by general practitioners in community health centers in Longhua District of Shenzhen through qualitative and quantitative studies.Methods:In qualitative study, 10 general practitioners (GPs) from community health centers in Longhua District of Shenzhen were selected by the purpose sampling method for personal in-depth interviews. The interview contents were recorded and transcribed, then coded by Nvivo software. Theme frame analysis method was used for data sorting and theme extraction. Based on the results of qualitative interviews, the questionnaire was developed and distributed through the electronic questionnaire platform. The contents of the questionnaire included general information, the situation of pediatric patient reception in community health centers, the willingness and ability of GPs to receive children, the existing problems and the measures to promote receiving pediatric patients in community health centers.Results:The results of personal in-depth interviews with 10 GPs showed that the obtained information reached saturation. Through repeated reading, induction and analysis of the interview data, four themes were extracted: ① GPs in community health centers received a large number of pediatric outpatients with common diseases; ② GPs in community health centers are willing to receive child patients, but they were lack of ability; ③ there were many problems of pediatric patients reception in community health centers; ④ training and incentive policies would help to promote child patient reception in community health centers. A total of 223 electronic questionnaires were collected, 219 of which were valid for analysis. All the community health centers in Longhua District received pediatric patients, the number accounted for 20%-60% of the total outpatients; 84.5%(185/219)of the responders were willing to receive child patients, 65.8% (144/219)of them assumed that the consulting ability was average. The main problems for GPs to receive pediatric patients were "insufficient training" (76.7%,168/219) and "lack of consulting ability" (55.3%,121/219). The important measures to promote GPs to receive child patients were to improve their own clinical competence (94.1%,206/219), to have clinical faculty with pediatric background mentoring at the community health center (74.9%,164/219), to improve the supporting facilities (42.9%,94/219) and continuous professional support (38.8%,85/219).Conclusion:The status quo of pediatric patient reception in the community of Shenzhen Longhua District is generally satisfactory. The main problems in this aspect are insufficient training for general practitioners and lack of clinical competence, which should be strengthened and improved in the future.
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Objective:To survey the working status of outpatient nurses in general practice departments of general hospitals.Methods:From March to April 2021, personal in-depth interviews were conducted with outpatient nurses from general practice residency training bases in Beijing. The thematic framework analysis method was used to analyze the interview data and refine the themes.Results:Fourteen nurses working in general practice outpatient clinics were interviewed in this study. Four themes were extracted from the interview data: (1) inadequate staffing of full-time outpatient nurses in general practice departments of comprehensive hospitals; (2) unclear job functions for outpatient nurses in general practice departments; (3) no standardized patient health education in the department; (4) no relevant training received systematically.Conclusion:General practice departments in general hospitals should setup full-time general practice nurse positions, clarify the job responsibilities, strengthen the relevant training and enhance core competency for nurses working in general practice department.
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Objective:To develop an online continuing education course of pediatrics for primary physicians using the ADDIE model and to evaluate its application effect.Methods:Experts in fields of general practice and pediatrics were invited to develop an online continuing education course of pediatrics for general practitioners using ADDIE model from June to July 2020. From August 2020 to September 2020 the course was conducted with 12 live sessions on the open platform. In September 2020, 16 primary pediatricians and 15 general practitioners who completed whole courses were invited to attend focus group interviews. The interview contents were recorded, transcribed, and coded using Nvivo software; the subject frame analysis method was used to sort the data and refine the theme.Results:Information was saturated by focus group interviews with 14 general practitioners and 14 pediatricians. Finally, three themes were extracted from the interview results:(1)The advantages of this course were practicality, comprehensiveness and online teaching; (2) The course improved the diagnosis and treatment ability of participants, increased self-confidence of doctors and satisfaction of patients, and also promoted academic exchanges among colleagues; (3) For future improvement of the course, the clinical knowledge points, practical procedures, new thinking of diagnosis and treatment, progress in guidelines, and knowledge depth should be added; and the use of case teaching and combination of online with offline, and extending teaching time should be considered.Conclusion:An online continuing education course of pediatrics for primary physicians has been developed based on the ADDIE model, which received favorable feedback from the primary pediatricians and general practitioners who attended the course.
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With the rapid population aging in China, healthy elderly care has become a consensus of the whole society. As an important part of healthcare system, community health service plays a vital role in health maintenance and promotion for the elderly, and it is an extremely important foundation for realizing healthy endowment. In this article we summarize the status quo of home-based care for the aged, in which the community health service plays an important role, and also make suggestions for further improvement.
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Objective:To investigate the status quo of the management of chronic obstructive pulmonary disease (COPD) in primary care health institutions in Miyun District of Beijing.Methods:The Measures to Improve Medical Services in Primary Medical and Health Institutions was issued by Beijing Municipal Health Commission in June 2019. In August 2020, a survey on COPD management status after the measures was conducted with self-designed questionnaire among 19 community health service centers and 61 general practitioners (GPs) from 4 centers in Miyun District of Beijing. Two questionnaires were used for the survey: one was on the status of medical institutions (institution questionnaire, filled by the person in charge of the center) and other was on COPD knowledge of general practitioners (doctor questionnaire, filled by selected GPs). Results:For health institution, 19 valid questionnaires were collected. Among them, 12 centers were equipped with lung function examination equipment after reform; 17 centers were equipped with inhaled corticosteroids/long acting β 2 receptor agonists (ICS/LABA); 12 centers carried out the contract management of family doctors for COPD; 267 patients signed the contract, 7 centers followed up the signed patients at least twice a year; 13 centers referred patients to Miyun District Hospital with 2 024 referrals per year. For GPs, 61 valid questionnaire were collected with a recovery rate of 100% (61/61). Among them 12 GPs (20%) had contracted management for COPD patients; 12 GPs (20%) had referred COPD patients to the secondary or tertiary hospitals; and 9/12 of GPs referred the patients for lung function examination due to the needs of diagnosis or follow-up.The mean COPD-related knowledge score was (58.9±20.0), compared with the score of 65 GPs from the 4 same community centers tested in 2018 (63.2±18.9), there was no significant difference ( t=0.456, P>0.05). Conclusions:The implementation of the primary care institution measures in Beijing promoted the management of COPD and improved capacity building in primary health institutions, also promoted the work docking between primary health institutions and secondary, tertiary hospitals. However, it is still necessary to strengthen the ability training of general practitioners in relevant knowledge and skills to improve their management ability of COPD.
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Objective:To analyze the status of prevention and control of COVID-19 in primary care institutions at the early stage of the epidemic.Methods:Thirty healthcare professionals from various places of China were recruited in the study from 6 thto 16 th February 2020 through WeChat platform advertising and by purposive sampling method. They were general practitioners (GPs), administrators, and other specialists, all of whom were involved in the prevention and control of COVID-19. Personal interview and focus group discussion were conducted online. The topic guide was as follows: (1) Introduction of the work that primary healthcare professionals carried out during the outbreak of COVID-19. (2) Difficulties and challenges that healthcare professionals encountered. (3) Opinions on the prevention and control of COVID-19. (4) Advices on future outbreak of similar epidemics or disease. NVivo 12 software system was used to code and classify the interview content, and thematic framework analysis was used to sort out and analyze the data and extract the interview themes. Results:Six themes were extracted: (1) The community hospital leaders led the work in time but job distribution and prevention procedures were insufficient; and the workload of GPs was heavy. (2) Primary care settings had carried out pre-screening and triage; while outpatient clinic continued to provide health care service for local residents, especially stressing online service and consultation to reduce the population mobility. (3) GPs should make full use of technical advantages and participate in joint prevention and control. (4) GPs offered various health education to residents to improve their awareness of self-protection. (5) GPs lacked professional skills and needed more related training, while the current training were still insufficient. (6) There were not enough supplies and GPs had increasing worries about the infection risks.Conclusions:GPs play an important role in effectively curbing the spread of the epidemic. It is suggested that the setting of triage and fever clinic in primary care institutions need to be readjusted; and the training of prevention and control knowledge and skill for GPs need to be strengthened in the future.
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Objective:To understand the coronavirus disease 2019(COVID-19)prevention and control work and the problems and difficulties faced by non-government primary medical institutions in China during the epidemic period.Methods:A survey on the coronavirus disease 2019(COVID-19)prevention and control work of non-government primary medical institutions was conducted on April 14 to 21, 2020 with the self-designed questionnaire. The questionnaire contained three parts: the first part was basic information of medical staff in non-government primary medical institutions, including position and institutional information; the second part was the status quo of non-government primary medical institutions participating in the prevention and control of COVID-19, including the specific work and difficulties faced by the responders during the epidemic period; and the third part was the prevention and control effect of COVID-19 in the responders′ institutions, including whether there were confirmed cases and infected medical staff. An online invitation was issued among the members of General Practice Branch of Chinese Non-government Medical Institution Association. The invited participants included the heads, general practitioners and other medical personnel of the non-government primary medical institutions the invited participants voluntarily scanned the online two-dimensional code to fill in.Results:A total of 761 individuals in primary health institutions from 20 provinces, municipalities and autonomous regions in China participated in the survey. There were 290 (38.1%) men and 471 (61.9%) women with age of 40(32, 48) years; 83.0% (632/761) had worked for more than 5 years; 33.8% (257/761) owned primary professional titles and 33.0% (251/761) owned intermediate titles. Among all participants 28.5% (217/761) were general practitioners, 26.9% (205/761) were institutions/department managers, 14.6% (111/761) were specialists and 40.3% (307/761) were other related personnel. A total of 549 institutions continued to operate during the epidemic period and 96.5% (530/549) participated in the work related to the prevention and control of the epidemic, including prescreening and triage, health consultation, follow-up of suspected patients, donation, quarantine of suspected cases, follow-up of close contacts/discharged patients, diagnosis and treatment of patients with new coronavirus pneumonia. 44.7% (340/761) of respondents participated in the epidemic prevention as front-line staff and directly contacted patients/suspected patients, and 63.1% (480/761) participated in the epidemic prevention work of primary medical institutions, including clinical outpatient service, prescreening triage and screening. The working sites were not limited to the institutions, but also other sites including high-speed railway station. The 97.8% (744/761) responders expressed their willingness to participate in epidemic prevention work under the unified leadership and command of the state. The 63.9% (486/761) of the responders were worried about the lack of protective equipments and measures, and 90.4% (688/761) respondents showed that they needed medical supplies (protective equipment: masks, goggles, protective gowns, etc.).Conclusion:The participation of non-government primary medical institutions and their staff in COVID-19 infection prevention and control is a key component of the epidemic prevention process.
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Objective:To investigate the current status of chronic respiratory disease (chronic obstructive pulmary disease, bronchial asthma and obstructive sleep apnea) management capacity in community health centers in Beijing Miyun district.Methods:From November 21 to 22,2018,nineteen community health centers and 65 general practitioners in Miyun district of Beijing were selected to participate in a questionnaire survey. The self-designed questionnaire was divided into two parts: the questionnaire for medical institutions(institution questionnaire)and questionnaire for general practitioners(doctor questionnaire). The institution questionnaires were distributed by the Miyun District Health Commission,and filled in by the person in charge of the institution; the knowledge questionnaires were sent to all general practitioners of 4 community health service centers. The two independent sample t test was used to compare the measurement data in accordance with normal distribution between the two groups, and analysis of variance was used for multi group comparison. Results:Nineteen institution questionnaires were sent to all centers in the district and all 19 valid questionnaires were recovered. Among them, 18 centers thought that chronic respiratory diseases should be included in the management of chronic non-communicable diseases, and health records should be established to achieve regular follow-up monitoring, but only one center had put asthma in the record. Nine centers purchased pulmonary function instrument; 8 centers were equipped with inhaled glucocorticoid, and 1 center was equipped with β 2-receptor agonists. The effective recovery rate of knowledge questionnaire was 100.0% (65/65). There was no significant difference in the knowledge scores of three kinds of chronic respiratory diseases (chronic obstructive pulmary disease, bronchial asthma, obstructive sleep apnea) among general practitioners [(63±19), (64±23), (62±21), F=0.087, P>0.05]. The scores of general practitioners with different ages and professional titles were (57±15), (66±13), (42±16) and (54±19), (67±12), (68±11) respectively. There were significant differences in the knowledge scores of general practitioners with different ages and professional titles ( F= 8.582 and 6.079, all P<0.05). The average scores of general practitioners with age>50 years or junior professional title were lower than others. Conclusions:The leaders of each center in Miyun district have a clear understanding of the necessity of diagnosis and treatment of chronic respiratory diseases, but there are still some problems, such as insufficient attention to chronic respiratory system, insufficient investment in disease management infrastructure, and lack of professional knowledge of chronic respiratory diseases among general practitioners. It is hoped that in the future, chronic respiratory diseases can be introduced into public health service projects, investment in related disease infrastructure will be strengthened, and comprehensive respiratory knowledge and ability training courses suitable for grass-roots general practitioners can be popularized as soon as possible.
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Asthma imposes a substantial burden on individuals and societies. Patients with asthma need high-quality primary care management; however, evidence suggests the quality of this care can be highly variable. Here we identify and report factors contributing to high-quality management. Twelve primary care global asthma experts, representing nine countries, identified key factors. A literature review (past 10 years) was performed to validate or refute the expert viewpoint. Key driving factors identified were: policy, clinical guidelines, rewards for performance, practice organisation and workforce. Further analysis established the relevant factor components. Review evidence supported the validity of each driver; however, impact on patient outcomes was uncertain. Single interventions (e.g. healthcare practitioner education) showed little effect; interventions driven by national policy (e.g. incentive schemes and teamworking) were more effective. The panel's opinion, supported by literature review, concluded that multiple primary care interventions offer greater benefit than any single intervention in asthma management.
Subject(s)
Asthma/therapy , Primary Health Care/methods , Quality Improvement , Health Policy , Humans , Practice Guidelines as Topic , Primary Health Care/standards , Quality of Health Care , Treatment OutcomeABSTRACT
BackgroundIn the beginning of January 2020, new unknown virus pneumonia cases started to emerge in local hospitals in Wuhan, China. This virus epidemic quickly became a public health emergency of international concern by the WHO. Enormous amount of medical supplies as well as healthcare personals from other provinces were mobilized to support Wuhan. This current work tent to help people understanding how infectious disease spread and the purpose and consequences of various efforts based on simulation model. Methoda simulation model was created using known parameters. R0 set to 3 and mean incubation time to be 7.5days. the epidemic was divided to 3 periods. Simulation would run 50 times to mimic different patient0 status. Personal activity index was used to mimic different level of control measures. 141427709 simulated patients were created. Cumulation number of patients at the end of period 1 (day50) is 2868.7{+/-}1739.0. Total infected patients could be 913396.5 {+/-} 559099.9 by the end of period 2 (day70) in free transmission state. And at day90, total patients number is 913396.5 {+/-} 559099.9. ConclusionCOVID-19 is a novel severe respiratory disease. This will put great burden on the shoulder of healthcare workers as well as on medical hardware and supplements. Current strict control measures help to contain disease from spreading. An early detecting, reporting and fast reacting system needs to be setup to prevent future unknown infectious disease.
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The ability of prevention, treatment and management of infectious diseases is a basic requirement for general practitioners. This article introduces our experience in the infectious disease rotation for general practice residency training, focusing on the rotation management at different stages of training to explore how to improve teaching quality and the ability of trainers in a short period of the rotation.
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The ability of prevention, treatment and management of infectious diseases is a basic requirement for general practitioners. This article introduces our experience in the infectious disease rotation for general practice residency training, focusing on the rotation management at different stages of training to explore how to improve teaching quality and the ability of trainers in a short period of the rotation.
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A well - established residency standardized training system is crucial for cultivating qualified general practitioners(GPs). The syllabus has regulated the goals, objectives, contents and forms of training, but not proposed the concrete and effective teaching and assessment models. This article reflects the existing problems in GP training regarding teaching faculty,rotation plan, outpatient teaching, feedback and evaluation mechanisms as well as the assessment methods and contents,the article also gives specific suggestions for future improvement in order to train competent GPs.
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Many clinical teachers who train general practice residents are specialists from other departments and are not fully familiar with the work of general practitioners.By socio-culturally adapting concepts from the Preceptor Education Project (PEP) developed over the past 25 years in the United States,this paper provides seven principles general practice residents can consider during rotations in other specialties.(1) Having clear learning objectives makes teaching and studying easier;(2) Teaching takes time,(3) Ask to be observed;(4) Teaching physicians should evaluate you;(5) Patients may resent meeting with a medical resident;(6) Make allies and treat them well;(7) Teach others.These principles can guide general practice residents to take responsibility for excellent training.
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This research summarized the exploration of English salon teaching on students in Department of General Practice,Peking University Health Science Center,illustrating thatthis teaching method was helpful to improve the students' English proficiency and theory of medicine,to promote communication and cohesion of the department,and to enhance the GP concept and competency.Based on the existing problems of English salon teaching,this research put forward the corresponding countermeasures so as to provide optimizing reference for teaching of GP,which included:(1)To encourage students to be active to participate inEnglish salon,correct the students' learning attitude and improve their learning methods,pay attention toteaching skills and take advantage of situational dialogue training methods;(2)To cultivate students' clinical thinking of diagnosis and treatment,urge the students to refer toliterature in time,takenotes and solve problemsas appropriate,as well as to promote supervisors' participation;(3)To recommend English salon teaching as an extension for thedelayed case-sharing.
